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A Case Study

September 18, 2007: Reducing Children's Exposure to Secondhand Smoke

Debbie Montgomery, M.P.H., Director, Secondhand Smoke Initiatives, Colorado Department of Health and Environment, State Tobacco Education and Prevention Partnership (STEPP)

Ms. Montgomery presented information on the development and implementation of Colorado's "ONE Step" Campaign. She began by providing a snapshot of Colorado and the state demographics, smoking prevalence and data on household and vehicle smoke-free rules in the state. Ms. Montgomery continued by describing the formation of a Secondhand Smoke and Children's Committee in December 2003 charged with developing a statewide plan to address the issue. One of the goals of this Committee was to develop an educational campaign for parents and to do so; qualitative research was conducted with healthcare providers, childcare providers and parents to determine the campaign's focus. The focus groups uncovered several misunderstandings that parents have about the effects of secondhand smoke. To address these myths, the "ONE Step" Campaign was created which encouraged parents to always smoke outside the home and car. Paid and earned media were part of the campaign, as were educational materials, a video and website. Ms. Montgomery showed the Committee a variety of the materials that were created to support the campaign including the website, advertisements, a toolkit for healthcare providers and child care toolkits.

A second goal of the Secondhand Smoke and Children's Committee was to develop guidelines for healthcare providers, and Ms. Montgomery presented information to the Committee on this effort. The guideline integrates secondhand smoke and cessation messaging, utilizes behavioral change coaching and pharmacotherapy, addresses time limitations by recommending "2 A's and an R" (Ask about tobacco use, Advise to quit and Refer to the Quitline) and approaches tobacco use as a chronic relapsing condition. 800 providers were trained in the use of these guidelines which led to 690,000 patients receiving the combined secondhand smoke and cessation message.

Ms. Montgomery described several community-based interventions that were part of the "ONE Step" Campaign. One such initiative was the Children's Hospital Pilot Project where children were screened for secondhand smoke exposure and providers were trained to provide intervention by referring parents to the state's Quitline if the parent acknowledged s/he was ready to quit.

Ms. Montgomery concluded her remarks by mentioning some of the state's evaluation plans as well as some planned future directions for the Campaign.

Following Ms. Montgomery's presentation, Admiral Moritsugu thanked the morning speakers and asked the Committee to take a one hour break for lunch.

Following the lunch break, Admiral Moritsugu introduced Elizabeth Cotsworth, Director of the Office of Radiation and Indoor Air at the Environmental Protection Agency, moderator of the afternoon roundtable discussion.

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